Sexuality in chronic respiratory failure: coincidences and divergences between patient and primary caregiver

AbstractSexual functioning can be affected by chronic illness in a variety of ways. These problems affect the patient's relationship and the degree of satisfaction with his partner. We conducted a study in order to evaluate the perception of sexual difficulties and changes in communication with patients and their wives. Male chronic obstructive pulmonary disease patients with (COPD) and chronic respiratory failure on long-term oxygen therapy were studied. The evaluation method used has consisted of the individualized administration of a semi-structured interview created for this purpose. This interview was conducted with the patients and their wives. One part of the interview was dedicated to evaluating possible sexual problems and how these problems affect the relationship between the couples. In addition, patients as well as their partners were asked the degree of satisfaction with their partners and the degree of satisfaction with their lives. Forty-nine patients and their spouses have been included in the study. Thirty-three patients (67·3%) showed some type of sexual problem (lack of desire and/or impotence). Sixteen wives (33%) answered affirmatively to the question about whether changes at a communicative level as a consequence of the patient's illness had occurred. In relation to the appearance of sexual changes, 46 (94%) of the wives answered affirmatively. The wives were significantly less satisfied with the relationship than the patients, which was related to communication problems. The group of patients were more satisfied with their partners than with their life, whereas no difference has been observed in the wives with both variables. An important percentage of patients with chronic insufficiency who have sexual difficulties exits. A factor which influences the perception of such problems in a very important way is the degree of affection in the relationship between the couples

Eliminación/Degradación de Triazinas Mediante Biorreactor de Membrana con Post-Tratamiento de Ozonización

The aim of the research was to evaluate the removal of micropollutants in a combined system MBR + ozonation. The research was carried out in a MBR scale laboratory plant which was fed with synthetic wastewater, doped with simazine (SIM), atrazine (ATZ) and terbutilazine (TBZ). The MBR operational conditions were: hydraulic retention time (HRT) of 20 h, organic loading rate (OLR) of 0.23 KgCOD/KgSSV·day, sludge retention time (SRT) of 30 d, and flux of 5.5 LMH. Two ozone doses were tested: low dose (16 mg O3/L) and high dose (45 mg O3/L). The removal eficiency of organic matter was 96%. For the studied triazines, low biodegradation effiencies were reached by biological treatment (MBR): 57%, 53% and 63% for SIM, ATZ and TBZ, respectively. The complementary treatment of ozonation improved the quality  of the effluents. At low ozonation dose the overall removal efficiencies increased to 95%, 92% and 96% for SIM, ATZ and TBZ, respectively. At high ozonization dose the overall removal efficiencies were 98%, 97% and 97 % for SIM, ATZ and TBZ, respectively, percentages slightly higher than those obtained at low dose. The results showed the combination of MBR + O3 is effective to remove micropollutants from wastewater, contributing to the preservation of a good ecological state of water bodies.Keywords: Bioreactor, Membrane, Ozone, Triazines, Herbicides

Methodology to improve water and energy use by proper irrigationscheduling in pressurised networks

With the aim of reducing energy consumption and improving water use in pressurised irrigation systems, the methodology to minimise energy consumption by grouping intakes of pressurised irrigation networks into sectors, as developed by Jimenez Bello et al. (2010a), was modified to enable irrigation intakes to operate during the scheduled period for each intake instead of operating during restricted irrigation periods of the same length. Moreover, a method was developed to detect the maximum number of intakes that can operate without extra energy if the source has sufficient head to feed at least some of the intakes. These methods were applied to a Mediterranean irrigation system, where the total cropped area was mainly citrus orchards. In this case study, water was allocated to two groups of intakes, one fed by gravity and the other by pumps. A saving of 36.3 % was achieved by increasing the total volume supplied by gravity, decreasing the injection pump head, and improving the pump performance. Therefore, all the intakes only operated during the irrigation periods at the minimum required pressure.This research was supported by funds from Climate-KIC AGADAPT and from EU 7th Framework Programme FIGARO projects. The authors wish to acknowledge the support provided by Picassent Sector XI staff. The revision of this paper was funded by "The Universitat Politecnica de Valencia, Spain".Jiménez Bello, MA.; Royuela Tomás, Á.; Manzano Juarez, J.; García Prats, A.; Martínez Alzamora, F. (2015). Methodology to improve water and energy use by proper irrigationscheduling in pressurised networks. Agricultural Water Management. 149:91-101. doi:10.1016/j.agwat.2014.10.026S9110114

Basal ganglia volume predicts speed processing performance in obese adolescents

La obesidad se ha relacionado con cambios estructurales en los ganglios basales y alteraciones en dominios transversales como la velocidad de procesamiento. El objetivo del presente estudio es investigar la relación entre velocidad de procesamiento y volumen de los ganglios basales en adolescentes con y sin obesidad. Treinta y tres participantes obesos y treinta y tres con peso normal fueron resonados (Siemens 3T Trio) y evaluados neuropsicológicamente. Se compararon los resultados de un índice de velocidad y la ratio de los ganglios basales controlando por edad, sexo y tamaño de la cabeza. Se realizaron regresiones lineales con las estructuras relacionadas con este índice. Se encontraron diferencias en el índice de velocidad, pero no en la ratio de los ganglios basales. El grupo con obesidad mostró una correlación positiva entre velocidad y ratio del globo pálido derecho (r= .41; p= .021). No hallamos relaciones significativas en el grupo normopeso. La ratio del globo pálido derecho predijo parte del rendimiento en velocidad en adolescentes obesos. Las diferencias en velocidad de procesamiento entre adolescentes con y sin obesidad podrían estar moderadas por el tamaño de estructuras subcorticales como el globo pálido.Obesity is related to structural changes in basal ganglia and alterations among transversal domains such as speed processing. The aim of the study is to address the relationship between speed processing and basal ganglia volumes in adolescents with and without obesity. Thirty-three obese and 33 normal-weight participants underwent MRI acquisition (Siemens 3T Trio) and neuropsychological assessment to obtain an index of speed processing. Speed processing index and basal ganglia ratios (VolBrain software) were compared controlling for age, sex and head size. Linear regressions were conducted in the structures related to such index. Groups differed for speed processing index, but did not differ for basal ganglia ratios. The obese group showed positive correlations between speed processing index and the right globus pallidum ratio (r= .41; p= .021). None relationship was found among normal-weight adolescents. Concretely, the right globus pallidum ratio predicted part of the performance in speed in obese participants. The differences in speed processing between adolescents with and without obesity might be mediated by the size of subcortical structures such as the globus pallidum

Non-motor symptom burden in patients with Parkinson's disease with impulse control disorders and compulsive behaviours : results from the COPPADIS cohort

The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson's disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose

Multisystem inflammatory syndrome in children in Western Countries? Decreasing Incidence as the pandemic progresses?: An observational multicenter international cross-sectional study

Background: SARS-CoV-2 variations as well as immune protection after previous infections and/or vaccination may have altered the incidence of multisystemic inflammatory syndrome in children (MIS-C). We aimed to report an international time-series analysis of the incidence of MIS-C to determine if there was a shift in the regions or countries included into the study. Methods: This is a multicenter, international, cross-sectional study. We collected the MIS-C incidence from the participant regions and countries for the period July 2020 to November 2021. We assessed the ratio between MIS-C cases and COVID-19 pediatric cases in children Transplantation and immunomodulatio

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries